Australia's Health Star Ratings Are A Dishonest, Misleading Mess

What is healthy these days? How does one go about eating "healthily"?

Who the hell knows. How could you know?

The definitions are constantly shifting. Before you needed carbs for energy, now you need less because carbs turn to sugar then fat. Then "healthy fats" became good for you, but what kind of fats? Satured? Unsaturated? Polyunsaturated? Where to begin?

But protein is good for you, right? Sure, but how much? Not too much. Consume too much and it literally sucks the calcium from your bones.

Then, the marketing. The marketing that, for all intents and purposes, lies to consumers regarding how healthy or unhealthy certain food products are. Then there's the sugar, which is addictive. Then there's the supermarkets themselves, designed to lure you in. Then there's consumer culture.

The struggle is real. Very real. It's extremely hard to eat healthy in the year 2017.

Compounding this: Health Star Ratings, the front-of-pack labelling system designed to help consumers make healthy choices.

It's being exploited, tampered with and presented to a public ill-equipped to make sense of them in the first place.

Milo, the most Australian of drinks, is perhaps the clearest example. Milo displays its 4.5 star rating proudly. A 4.5 stars that only applies if Milo is consumed with a very specific amount of skimmed milk. If the health star rating was based solely on Milo's own nutritional values -- eaten straight from the tin -- it would actually score 1.5 stars, not 4.5.

Milo literally receives a higher health star rating if eaten with ice-cream.

Yet the 4.5 star rating sits on the tin, not 1.5.

The system is rife with bizarre contradictions like this.

Certain brands of clean, unsweetened Greek yoghurts sit at 1.5 stars. Some lolly bags sit at 2.5.

Sugary cereals regularly score 4 stars.

Salmon sits at 3 stars, beer battered chips sit at 4.

Health Star Ratings are fundamentally broken.

Image: Choice

"The final algorithm used was prepared by the food industry and has a few anomalies."

That's Rosemary Stanton. She's been a renowned nutritionist for 50 years. Rosemary was part of the original Working Party asked to design the Health Star Ratings. A change of government saw her removed from the final committee; a committee that featured no nutritionists whatsoever.

Ultimately Rosemary had nothing to do with the Health Star Ratings as they currently exist. She's very disappointed with the results.

According to Rosemary, the system was designed to reduce Australian intake of certain nutrients (like salt, saturated fats and sugar) and never truly functioned as an arbiter of what's "healthy". It's an algorithm skewed to favour increases in certain other nutrients. Nutrients that don't necessarily contribute to general health but make it relatively easy for food companies to game the system.

An example: Australians generally don't consume enough fibre, so the Health Star Rating's algorithm favours foods with high fibre content. "Products containing additional dietary fibre can get bonus points which can be used to offset negative points they get for saturated fat or sugar," Rosemary says.

Bonus points like these allow Kellogg's to add fibre to its cereal formula for additional stars. This is how a product like Nutrigrain gets a 4 star rating despite the fact it's still literally 27 per cent sugar.

"A food technologist can 'manipulate' many highly processed products to get more stars," explains Rosemary. "For example, they can add inulin -- a white powder that counts as dietary fibre. They can boost protein by adding soy protein isolate or milk powder."

The issue: Health Star Ratings are not designed to rate products based on their overall "healthiness". They're designed to attack a handful of key deficiencies in the Australian diet.

The end result: A system that confuses consumers instead of informing them.

Worse still, most consumers aren't aware that Health Star Ratings are designed to be compared only to products in their category. It isn't a catch-all rating that judges a product's health level compared to other packaged foods.

This is why some organic nuts can literally rate the same as lollies in the sweets aisle. This is why sugary cereal can rate higher than packaged salmon. Macadamia nuts are being ranked compared to almonds or walnuts. Salmon is being compared with other types of packaged fish like tuna.

Most consumers are completely unaware of this.

Aloysa Hourigan is Program Manager at Nutrition Australia. She sees the Health Star Ratings as an improvement upon previous box labelling -- they're more visual, easier to parse than previous attempts like the Nutritional Information Panel. But she admits there's work to be done.

"More consumer education is required," she says.

Currently Health Star Ratings are not mandatory. It's an opt-in scheme and companies will rarely opt-in unless there are benefits. The end result: There are very few products out there with low ratings, which makes for a faulty spectrum on what is healthy and what isn't.

"There is room for improvement," continues Aloysa. "Especially making it mandatory and extending it to include less healthy foods."

Currently the Health Star Ratings only apply to packaged foods. Rosemary Stanton sees this as a missed opportunity: She believes ratings should be applied to fresh fruit and vegetables. She says all unprocessed fruits, vegetables, nuts and seeds should automatically be given 5 stars, whereas discretionary junk foods should never rate higher than 2.5 stars.

"Some kind of Health Star Ratings system would be a good thing," believes Rosemary, "but its current incarnation is flawed.

"My own preference is to look at foods rather than nutrients."

Nestle believes it is perfectly within its rights to present Milo as a 4.5 star drink despite its nutritional value actually sitting at 1.5 stars.

"The rating has been taken to represent food as prepared," a representative said. "The health star rating as you consume it.

"Milo is consumed in 90% of cases with milk."

As you might expect, Nestle is a fan of the Health Star Rating in general.

"We think the health star ratings are a good thing," a representative told us.

"We’ve made the commitment to add the HSR to our products."

Nestle's only issue: Not enough companies have matched their commitment. They'd like to see more companies commit to using the ratings system. Nestle defends the government's choice to rate foods by category.

Image: iStock

"The government is trying to communicate within categories," said Nestle. "The real intention is to help consumers at point of sale to make a decision within a category."

Surprisingly CHOICE, Australia's most recognisable not for profit consumer organisation, agrees.

CHOICE has been quick to call out companies like Nestle for their misleading use of the Health Star Ratings system, and recently urged regulators to expand and strengthen the scheme, but it feels -- for the most part -- that the Health Star Rating system is a good one.

"From where we were to where we are today," said a CHOICE representative, "the health stars have been a significant step in the right direction."

A surprising statement, but perhaps not too surprising. CHOICE was part of the committee that helped create Health Star Ratings in the first place.

"Yes, we had input into the process along the way alongside other groups," CHOICE admits. "Because our research had shown that the healthy intake guide was ineffective.

"We knew the system needed to be improved and were happy to be involved in that process."

But regardless of their involvement, CHOICE has proactively called out flaws in the system, but these tend to be directed at companies trying manipulate the system. CHOICE rarely criticise the system itself.

In a recent post they made calls to "strengthen" and "expand" the existing scheme, and refer to examples like Milo and Nutrigrain as "anomalies".

"These cases," believe CHOICE, "undermine the positive effect of Health Star Ratings in the marketplace."

Unlike nutritionist Rosemary Stanton, CHOICE believes that food companies reformulating cereal to gain additional health stars is a good thing. Better for Nutrigrain to have less sugar than more. Better for it to have more fibre than less.

"We think it's a good system. Massive improvement.

"That's clearly how the health star system has worked. If we had the intake guide, it's unlikely these healthier reformulations would have come into the market place."

Image: iStock

There's a pragmatism to the Health Star Ratings, but very clear issues. We're at a crossroads: Either the government commits to a dramatically higher level of consumer education or it reinvents the Health Star Ratings completely.

Rosemary Stanton clearly believes the system needs a reboot, Aloysa Hourigan more conservative.

"All labelling systems have their failings," she believes.

"More consumer education is required to understand the HSR system. This is probably a better strategy than developing a brand new system.

What does that education look like? More point-of-sale information, increased government spending, and a better relationship with health professionals would be a good start, says Aloysa.

The good news: A report is due in the middle of this year that reviews the first two years of the Health Star Rating. Later, post-2019 a fully fledged five year review will take place. A Technical Advisory Committee has already been established for that purpose and -- thankfully -- there's a nutritionist on board this time (Rosemary Stanton approved no less).

Rosemary believes this is in response to the numerous complaints made about the system.

CHOICE, to its credit, released its own two year report that addressed many of the concerns that nutritionists like Rosemary Stanton have with Health Star Ratings, but was complimentary of its reach, visibility and ability to communicate basic nutritional information.

But the problem lies in the quality and accuracy of that information. That's what needs to change.


    If they're serious about fixing it, the initial panels would need to be dominated by biochemists and they should be continually referred to through the process. Then - in a rough order - it should be medical practitioners, nutritionists, then politicians, then industry.

    Instead you've got the latter two over-involved in the early planning stages of each proposal, and dogmatic types, particularly amongst the medical and nutritional groups, shouting people down with fuzzy epidemiological evidence and a general fear of change.

    After a quick glance at some of the panels, I can only see Dr Anne Astin possessing a biochem degree, and she's been working in and around public policy for 30 years, not so much working the science (happy to be corrected if there were more biochemists involved).

    By putting the names of such researchers a little more in the spotlight, that naturally puts their work into the conversation more, and unshackles them from the over-simplified nonsense that often comes out at the end of the pipeline, and waters down the influence of the food industry to bump up their chances in such systems.

    I mean, imagine creating building standards, and the vast majority of the people making the final call were tradies (not to say tradies don't know their stuff, just that they usually aren't material and structural engineers on the side) and real estate agents or commercial developers. It's utterly fucking mindboggling that this is done with high-level science.

    PS - Mark, please stop eliciting public commentary from me by being on the money with your articles

    Last edited 16/03/17 12:10 pm

      The food industry (people creating and providing the products) shouldn't even be involved tbh. It should be completely independent of them (managed by biochemists, medical practitioners and nutritionists as you stated). The algorithms or criteria for judging food should be kept secret from the food industry to prevent them from gaming the system.

        I agree, but they should also be people that are in no way linked to funding from food industry also. Many of the universities and research institutes are funded by the food industry and therefore have a vested interest in certain outcomes.

      I know the politicians part was a jab at keeping the food industry at the bottom, but I had this flash image in my head of a Weetbix television ad with the narrator saying "five out of seven Tony Abbotts agree it's good for you!".

    I dont even bother with the health star system these days, prefering to go by the proportion of daily requirements - mainly sugar. Anything more than 10g of sugar is enough for me to put a product back, and make me suspicious.

    Milo also abuses the GI rating system in the same way. It hands itself a low GI rating, specifically when mixed with skim milk, when in fact its quite high.

    To a diabetic, that can be dangerous.

    There needs to be an overhaul of these sorts of ratings, because they are being abused in the name of profit, to the consumers detriment. I can accept advertising, like Nutri Grain being linked to Ironman events, thats just good business, but when efforts to do the right thing by consumers are abused on technicalities, its time for authorities to shut them down.

    Make the ratings be based on the product itself, and not after combination with other products. Its that simple. Like unit ratings on supermarket shelves, the option needs to be taken out of the manufacturers hands, and put into the consumer domain. Its a nanny state idea, but for once, one that's a positive step.

      Setting ridiculous small portion sizes on product labelling is one way that health ratings are gamed.

        That is the reason I only ever look at the per 100g column. Just give the the percentage of sugar and that will let me know what it is like. In stead of hmm this block of chocolate is onnly 5% of my sugar rdi. Assuming I only end 2 squares of the block.

          So much this. The best thing they did was the nutritional breakdown per 100gm of every packaged food. That is the even playing field. And to be honest if you as a consumer can't be bothered picking a packet up and reading that info box on the side then you don't really care what you are eating anyway.

            The laughable case is take-away drinks that get described as multiple portions. Really???

              My favourite one of those was a little tub of yougurt (The kind that come as a snap off 6 pack) that was 2 serves

    This bucket of KFC is 5 stars provided I don't actually eat it.

      They should show skinless KFC chicken, served with broccoli and spinach on the bucket.

    I remember when the system was first being floated, and my feedback was that a single-dimensional health measure was prime for gaming right from the outset. CHOICE didn't like that feedback.

    Consumer education is going to have to deal with the very real issue of faulty cognitive biases when making comparisons (the stuff that Kahneman and Tversky worked on).

    Yet another example of mega-rich corporations getting away with doing whatever the hell they like. The Government is just a puppet, if they weren't they'd put more oversight into place and give those oversight agencies some bloody teeth. I know I keep banging on about this, but bloody hell, when will the populace stand up and fight back? You want to see where this is going? check out what's happening now in the US. I watched 4 Corners this week, with their story on the poor in the US and the conditions they are forced to put up with, it's a bloody disgrace. They reckon unemployment has dropped and that the economy is doing well, but they don't tell you that 50% of those new jobs are paying well below the poverty line and their employees are virtual slaves.

    I feel for anyone trying to eat healthy and relying on these sort of systems. During my weight loss journey I discovered a lot about food and how unreliable the system is.

    I go by how much per 100g now. Reading the actual label is the best way to educate yourself on foods, and also keep an eye out for hidden sugars in the ingredients

    Worse still, most consumers aren't aware that Health Star Ratings are designed to be compared only to products in their category.I don't pay any attention to the star rating, but I would have assumed they were reflective of overall "healthiness" across all foodstuffs.

    By this definition a bag of nails can give itself a five-star rating as long as they're not as sharp as other bags of nails.
    "Our nails are the least unhealthy nails you can eat!"

      Comparing against products in the same category makes sense to me
      The difference between a 1 star rated pie and a 4 star rated pie is more useful than then saying they are both 1 star

        That seems like a limitation of only having five stars to work with though. What if they were percentages, and you were comparing a 15% pie against a 12% pie?

          But I don't have 15 fingers to count that high so I don't think it will work for the general public.
          Possibly reworking the framework to deal with it but trying to get a formula that would be accurate to that level is going to be a nightmare

    This star system is too simplistic and easily gamed.

    But it's only one of the many ways manufacturers psychologically trick us. These include words like "natural" and "organic", as well as gimmicks like touting products as ideal for kids' school lunchboxes.

    The Checkout have run a few pieces around these which are still available on iView

    I tend to agree with Choice - we need a simple way to view the health of a product. A complex table will never be used by the masses. A simple star system will be gamed - BUT - as they say, it is driving change in the way the companies create their products. Cereals have more dietary fibre - and the reality is that I was always going to grab that packet of cereal - at least now I know it is just bad for me - not awful... And also we are seeing where companies can make a difference and where they cannot. i.e. some cereals have been reformulated with less sugar and more fibre to get a better health rating - and are still edible. Others (like Cheerios) are freaking disgusting ion the new formulation - which basically says they can't make that product healthy without making it awful at the same time. Uncle Tobys have their original and their healthier muesli bars - they taste different, but i will always choose the healthier option for my kids. Are they "healthy" - probably not - are they better than the original ones that I used to buy ignorantly without any view of the nutrition - probably.

    Whatever happened to the Coalition's health star-rating website?

    Oh, that's right!

    "Nationals Senator Fiona Nash was mired in scandal and facing calls to resign from the Abbott government frontbench. It had been revealed that her chief-of-staff, Alastair Furnival, was co-owner of a company lobbying for soft drink and confectionary companies when she had intervened in pulling down a new health star-rating website at the time she was assistant minister for health."

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